hypersomni

Hypersomnia is a sleep disorder characterized by excessive daytime sleepiness or prolonged nighttime sleep that is not refreshing, despite taking adequate opportunities to sleep. People with hypersomnia may struggle to stay awake during the day, experience unplanned naps, and have difficulty waking from sleep. The condition can significantly affect daily functioning, work, and social life.

Classification and types. Hypersomnolence is grouped under central disorders of hypersomnolence in many medical classifications. Major subtypes include narcolepsy type 1 (narcolepsy with cataplexy) and narcolepsy type 2, idiopathic hypersomnia, and hypersomnia due to another medical or sleep disorder (such as sleep apnea or mental health conditions). There are also episodic or recurrent forms, such as Kleine-Levin syndrome, which involve periods of prolonged sleep with告acute behavioral changes.

Causes and risk factors. Hypersomnia can be primary (idiopathic) or secondary to other conditions. Potential factors include genetic predisposition, autoimmune processes affecting wake-promoting brain systems, brain injury, infections, metabolic disorders, sleep deprivation, or untreated other sleep disorders. Narcolepsy, for example, is often linked to a deficiency of hypocretin (orexin) in the brain.

Diagnosis. Evaluation typically involves a detailed history, sleep diaries or actigraphy, and overnight polysomnography to assess sleep quality and structure. A multiple sleep latency test (MSLT) is commonly used to measure daytime sleepiness and to help distinguish narcolepsy from other causes. Diagnosis also requires evaluating and ruling out other medical, psychiatric, or lifestyle factors that can cause sleepiness.

Treatment and management. Management focuses on improving alertness and maintaining regular sleep schedules. This may include scheduled daytime naps, treatment of any coexisting sleep disorders, and lifestyle adjustments. Pharmacological options include wake-promoting agents such as modafinil or armodafinil, stimulant medications when appropriate, and, in some cases, other drugs like sodium oxybate for narcolepsy. The approach is individualized and aimed at reducing daytime sleepiness and improving function and quality of life.